VOLUNTEER APPLICATION FORM

Note: The CCSPCA complies with the Privacy Act, (which governs the collection, use and dissemination of personal information) and does not sell, barter, lend or lease any personal information it has or obtains.

Name

First NameLast Name

Email

example@example.com

Phone Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Age

Do you follow us on Facebook (facebook.com/CCAnimalShelter)?

What is the BEST way to contact you?

Emergency Contact

First NameLast Name

Relationship to Applicant

Phone Number

Area CodePhone Number

Do you have any experience working with animals?

If so, when and in what capacity?

Which areas are you interested in volunteering?

When are you available for Volunteering?

Times

Other

CAT SOCIAL Volunteering is an initiative to recruit volunteers who will spend time with, socialize, and encourage shy or anti-social cats staying at the Charlotte County Animal Shelter. These sessions take place on Wednesday afternoons in 30-minute time slots. The session will involve interacting with one cat at a time. The goal is to encourage the cat to become more comfortable with human interaction and playing.

This program is not adoption consultation sessions. Once you've submitted your application, the Shelter Ambassador will call you to book an appointment as cats become available for socializing.

Please note: Volunteers that are between the ages of 10 and 16 must always be accompanied by a legal parent or guardian.

Are you interested in participating in our Cat Socials?

Please indicate what time slots you would be available for Cat Social volunteering on Wednesdays:

In signing this form, I acknowledge/accept that despite the best efforts/intentions of the C.C.S.P.C.A. Inc., it is impossible to completely predict nor control the behavior of any animal. I recognize/accept complete responsibility for the risks involved in working with animals. Therefore, I hold the Charlotte County Society for the Prevention of Cruelty to Animals, Incorporated (C.C.S.P.C.A. Inc.) completely free from: any/all liability for any/all injury to myself or damage to my property or any/all illnesses or medical condition(s) that may be contracted or result of my volunteering time at C.C.S.P.C.A. Inc. shelter. I agree to follow all C.C.S.P.C.A. Inc. shelter procedures/policies and all instructions given by C.C.S.P.C.A. Inc. staff while I am volunteering. I agree to hold in strict confidence, and not use, divulge, disclose, or communicate to any person or entity any information relating to the identity of C.C.S.P.C.A. Inc. animals, customers, employees, volunteers, board members, financial records, euthanasia, health information or inventories as long as such information is not generally known to others outside the C.C.S.P.C.A. Inc. Volunteers that are between the ages of 10 and 16 must always be accompanied by a legal parent or guardian. Volunteers must be at least 19 years of age or older to walk dogs. The C.C.S.P.C.A. Inc. complies with the Privacy Act (which governs the collection, use, and dissemination of personal information) and does not sell, barter, lend, or lease any personal information it has or obtains.

Signature

First NameLast Name

Date Signed and Submitted

Date

Legal parents or guardians must sign for applicants under the age of 18.

Signature